Role of systemic inflammatory markers (biomarkers) as important prognostic factors for survival in head and neck cancer

Introduction and Aim: Cancer related inflammation is recognized as a critical multifaceted player in tumour initiation and progression. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are important markers of systemic inflammatory burden in malignancy. The present retrospective study aimed to evaluate the prognostic value of pre-treatment baseline (NLR) and (PLR) for survival in HNC patients. Materials and Methods: Analysis of data of 257 patients with head and neck cancer treated with definitive therapy over 3.5 yrs. Neutrophil, lymphocyte and platelet counts before treatment of all patients were collected and NLR and PLR were calculated. Results: Median value of NLR and PLR were 3.7 and 170.63 respectively. Receiver operator characteristics (ROC) curve analysis showed the predictive cut-off value of NLR and PLR as 3.9 and 158.3. Univariate analysis using Cox-regression model showed NLR (p < 0.001) and PLR (p = 0.001) significantly influenced the locoregional recurrence free survival (LRRFS) and overall survival (OS). The multivariate analysis showed NLR is the independent prognostic factors influencing LRRFS (p = 0.007) and OS (p = 0.002). Kaplan-Meier survival curve (Log rank test; Chi-square (?2) value) showed OS is significantly influenced by NLR group (LRRFS; ?2 = 23.9 and OS; ?2 = 33.7) and PLR group (LRRFS; ?2 = 11.2 and OS; ?2 = 19.3) in contrast to LRRFS. Conclusion: NLR can be strongly used as biomarker for prognostication for outcome and survival in head neck cancer. However, a well-designed, larger studies with longer follow-up is warranted.

Efektivitas Agen Pendeplesi GSH pada Sitotoksisitas Cisplatin terhadap Sel Kanker: Systematic Literature Review

Cisplatin is one of chemotherapy agent for long cancer, ovarium cancer, gastric cancer, breast cancer, head-neck cancer. However, in the fact, the role of cisplatin does not always provide an optimal effect because it often appears cancer cell resistance phenomenon to cisplatin. This resistance condition occurs partly due to the inactive metabolite cause of conjugation reaction between cisplatin and GSH in cancer cells. Therefore, gluthathione (GSH) has an important role in controlling cisplatin resistance. This study aims to analyze some combination of cisplatin and the depletion agent of gluthathione (GSH) as a support for cisplatin activity in several types of cancer cells within in vitro scope. This study is prepared using systematic literature review method. Library search were carried out on two accredited international journals databases, namely PubMed and Science Direct with interval years of publication in 2011-2020. From 10 selected journals, it was shown that the use of GSH depletion agents could enhance the cytotoxic effect of cisplatin. This was analyzed based on data of the number measured GSH cells and the number of living cells (% cell viability) which gave a significant decrease. The result of research are expected to be able to provide information for the development of therapeutic agents on cisplatin as chemotherapy.

Estimation of Radiotherapy Efficiency of Head-and-Neck Cancer Based

Purpose: Evaluation of the expected effectiveness of radiation therapy based on models of the local tumor control probability (Tumor Control Probability – TCP) for the head-neck cancer. Material and methods: The study used data from 11 patients with locally advanced head-neck cancer (larynx, oropharynx, and oral cavity). For each patient two dosimetric treatment plans have been prepared: SIB-VMAT (70 Gy per tumor, 50 Gy per lymph nodes, 25 fractions) and SEQ-VMAT (70 Gy per tumor, 50 Gy per lymph nodes, 35 fractions). The developed plans were analyzed using A. Niemierko's TCP model with parameters obtained by B. Maciejewski (TCD50 = 70.26 Gy with a 49-day total treatment time), taking into account the dose–volume histograms and the total treatment time. Results: The developed plans ensured a high level of coverage (98–98 %) of the Clinical treatment volume (CTV) in all but one patient. The average TCP SIB-VMAT is 99.9 % due to the very short total treatment time. The average TCP for SEQ-VMAT is 61.0%. For one patient, both SIB-VMAT and SEQ-VMAT showed zero expected efficacy due to 95–95 % CTV coverage. Conclusion: The use of TCP model allows analyzing personalized treatment plans for patients and developing adaptive treatment regimens with an increase in the total dose, dose per fraction, and a decrease in the total treatment time.

Systematic Analysis and Identification of Dysregulated Panel lncRNAs Contributing to Poor Prognosis in Head-Neck Cancer

Head and neck cancer (HNC) is one of the most prevalent cancers worldwide, accounting for approximately 5% of all cancers. While the underlying molecules and their pathogenetic mechanisms in HNC have yet to be well elucidated, recent studies have shown that dysregulation of lncRNAs may disrupt the homeostasis of various biological pathways. However, the understanding of lncRNAs in HNC is still limited by the lack of expression profiling. In the present study, we employed a systematic strategy to identify a panel of lncRNA associated with HNC. A cancer-related lncRNA profile PCR array was screened to explore potential molecules specific for HNC. A total of 55 lncRNAs were found to be dysregulated in HNC cells when compared to normal keratinocytes. Further analysis of the prognostic significance using The Cancer Genome Atlas (TCGA) database revealed 15 lncRNAs highly correlated with overall survival in HNC patients. Additionally, clinical sample expression analysis of the TCGA-HNSC cohort revealed 16 highly dysregulated lncRNAs in HNC, resulting in a combined 31-lncRNA signature panel that could predict prognosis. Validation of these molecules confirmed the considerable level of altered expressions in HNC cells, with XIST, HOXA11-AS, TSIX, MALAT1, WT1-AS, and IPW being the most prominently dysregulated. We further selected a molecule from our panel (XIST) to confirm the validity of these lncRNAs in the regulation of cancer aggressiveness. Gene ontology (GO) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analyses demonstrated that XIST participated in various cancer-related functions, including cell proliferation and metastasis. XIST silencing with the RNAi technique substantially reduced invasion and migration in several HNC cell lines. Thus, our study defined a 31-lncRNA panel as prognostic signatures in HNC. These perspective results provide a knowledge foundation for further application of these molecules in precision medicine.

Older adult guidelines: What is patient reported experience across five cancer programs?

186 Background: ASCO’s Guideline for Geriatric Oncology (Mohile SG, Et al 2018) and NCCN’s Guideline for Older Adult Oncology (v1.2021) include patient self-assessment for falls, memory/concentration, and activities of daily living. Our study collected patient reported experience with self-assessing these concerns, discussing them with clinicians, and receiving relevant referrals across adult patients with cancer. We also examined differences in reported experiences between younger and older patients. Methods: We surveyed patients 18 and over with breast, colorectal, lung or head neck cancer who received care from January 2020 to April 2021 across 5 cancer programs in Chicago: 3 academic and 2 community based. Survey included 7 items adapted from older adult oncology guidelines and associated instruments including PROMIS. Analyses used chi-square method with Yate’s correction. Results: 243 patients completed a survey, about half over and half under 65. Only 16% of patients reported that clinicians asked them about falls/walking, concentration/memory, or daily activity concerns; an additional 28% of patients brought up these concerns with clinicians (Table). Over half (51%) of all patients had at least once concern, 17% falls/walking, 30% concentration/memory and 35% daily activities. About 1/3 (35%) of patients were referred to services. Importantly, the rates of experiencing concerns associated with older adult care, initiating relevant discussions with clinicians, and receiving referrals were similar between younger and older patients (Table). Patients with concerns were more likely to get PT/OT, Geriatrics, or home health support, p =.02, p =.03, p =.04, respectively (data not shown). Conclusions: Regardless of age, half of patients reported at least one concern that is typically associated with older cancer patients. Future studies should study concerns for falls, memory, concentration, and daily activities among younger patients, with the potential to expand the guidelines accordingly. We also found gaps in identifying these concerns even within the older patient cohort, suggesting that quality improvement interventions are necessary.[Table: see text]

Neutrophil-to-Lymphocyte Ratio as a Factor Predicting Radiotherapy Induced Oral Mucositis in Head Neck Cancer Patients Treated with Radiotherapy

Background: The objective of this research conducted in head and neck cancer (HNC) patients was the assessment of the relationship between neutrophil-to-lymphocyte ratio (NLR) and the incidence of severe radiotherapy (RT) induced oral mucositis (OM), as well as overall survival (OS). Methods: The study involved 207 patients in advanced stages (III–IV) of HNC. RTOG/EORTC scale was used to assess OM. The pre-treatment NLR was specified as the absolute neutrophil count divided by the absolute lymphocyte count. Results: Starting from second to seventh week of RT, we observed a significant, positive correlation between NLR values and OM grade. From the second to seventh week of RT, higher NLR values were related with significant increases (from 2- to over 24-fold) in the risk of occurrence of more severe OM (multivariate analysis confirmed its independent influence). Moreover, multivariate analysis for survival revealed that both higher TNM stage (HR = 1.84; p = 0.0043) and higher NLR values (HR = 1.48; p = 0.0395) were independent prognostic factors. Conclusion: NLR is a simple and accurate parameter that is useful in the evaluation of the risk of more severe OM, as well as an independent prognostic factor of OS in patients subjected to RT due to HNC.